Medical Specialties Commons^™

Cost Effectiveness Of Sending Of Routine Collection Of Sinus Contents In Skull-Base Patients, Jonathan Grey, Caroline Roberts, Amanda Bachand, Jacob Keeley, Adam Folbe

Posters

• Following endoscopic skull-base surgeries, it is common practice to send sinus contents for histopathological review and examination, in addition to the tumor/pathology itself.
• Histologic analysis of standard surgical specimens has long been thought to enhance diagnostic precision, ensure quality control, and offer procedural documentation.1 However, with rising healthcare costs, the necessity of this practice has been challenged in specific situations, such as this one.1
• In this study, we sought to determine if the regular collection of sinus contents uncovers another disease process or informs clinical decision-making.
• We also determined the cost of routinely sending sinus contents to pathology for evaluation. …

A Quantitative Analysis On The Locations Of Phase 3 Retina Trials In The United States Over The Past 5 Years, Shahrukh Naseer, Tarek Hassan

Posters

• Clinical trials are essential for advancing treatments in ophthalmology, yet comprehensive data on institutional participation in Phase 3 retina trials is not readily available.

• The U.S. National Library of Medicine Clinical Trials database (NLM database) lists individual research sites for each study; however, aggregating and visualizing this data remains challenging.

• The lack of centralized and easily interpretable data on research site participation hinders understanding of institutional contributions to retinal clinical research.

• Identifying geographic and institutional trends can improve resource allocation and research collaboration.

• We aim to

• Quantify the number of unique institutions participating in …

Enhancing The Eden Alternative Model With Well Standards: A Case Study Analysis, Mariah Stoner

Architecture Masters of Science Program: Theses

This thesis investigates the potential for improving the Eden Alternative Model, a person-centered approach to elder care that emphasizes creating a homelike environment and meaningful relationships, using WELL Standards, a building certification system focused on enhancing human health and well-being through improvements in environmental quality. Through a mixed-methods approach involving quantitative data analysis and qualitative case studies, this research examines how WELL Standards, which cover aspects such as air quality, water quality, lighting, and thermal comfort, can improve environmental quality and resident satisfaction within the Eden Alternative Model. This research introduces a tailored approach to elder care by combining these …

Implementing Early Detection Of Cognitive Impairment In Primary Care To Improve Care For Older Adults, Nicole R. Fowler, Katherine A. Partrick, James Taylor, Michael Hornbecker, Malaz Boustani, Jeffrey L. Cummings, Tim Macleod, Michelle M. Mielke, Jared R. Brosch, Chinedu Momoh

Brain and Mind Institute

Primary care is the ideal setting for early detection of mild cognitive impairment (MCI) and Alzheimer's disease and related dementias (ADRD), as it serves as the primary point of care for most older adults. With the growing aging population, reliance on specialists for detection and diagnosis is unsustainable, highlighting the need for primary care-led assessment. Recent research findings on successful brain health prevention strategies, AD diagnostic tools, and anti-amyloid treatments empower primary care to play a central role in early detection and intervention. Primary care-focused resources are being developed, including tools for cognitive assessments and materials designed to educate patients …

Rare Jugular Bulb Tumor Presenting As Bilateral Papilledema, Yoona Choe, Matthew Boyle, Peter Maduka

Rowan-Virtua Research Day

Optic disc edema, which may arise from a range of inflammatory, ischemic, compressive, infiltrative, or hereditary causes, can also indicate elevated intracranial pressure in the form of papilledema. Given its potential association with life-threatening conditions such as mass lesions or venous sinus thrombosis, timely identification and thorough evaluation are critical. In this case, a 61-year-old female presented with a complaint of a new-onset floater in her left eye. Despite minimal symptoms and an unremarkable systemic review, dilated fundus examination revealed bilateral optic disc edema with hyperemia and hemorrhages, prompting urgent neuroimaging. MRI and MRV identified venous thrombi in the right …

The Effective Utilization Of Artificial Intelligence (Ai) In Early Melanoma Detection, Svetlana Filiche

Rowan-Virtua Research Day

Background:

Melanoma, while comprising only 1% of skin cancer cases, accounts for a high mortality rate due to its ability to metastasize if not detected early. Traditional face-to-face dermatologic evaluations provide limited access to care, resulting in delayed diagnoses.

Significance:

Artificial Intelligence (AI) offers a novel approach to improve diagnostic accuracy and accessibility by alleviating strain on healthcare resources in medically underserved areas.

Methods:

A literature review was conducted using studies published in the last ten years. Eligible resources included case reports, clinical studies, clinical trials, meta-analyses, reviews, and systematic reviews in English. Studies that were repetitive or inapplicable were …

Broadening And Broadcasting The Impact Of Cardiovascular Risk Factors Among Muslim Residents Of Southern New Jersey With Special Emphasis On Opportunities Of Future Interventions And Prevention Tactics, Maikel Mansour, Ocean Alam, Samiha Hossain, Kirsten M. Carlberg, Katarina Rusinak

Rowan-Virtua Research Day

According to AHA and NIH, CVD includes stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease. Between 2017 and 2020, 127.9 million US adults (48.6%) had some form of CVD.

Among the target population, it was found that observing Ramadan fasting leads to an increase in total cholesterol, low-density lipoprotein cholesterol, and triglycerides levels post-fasting. Yet, Islam emphasizes the importance of physical health as a privilege from God (Allah (swt)) and is seen as a religious duty.

The objective of the HCOP service project was to investigate the …

The Relationship Between Running Cadence And Stress Fractures In Competitive Distance Runners, Jason A. Richwall

Rowan-Virtua Research Day

Running is one of the most popular sports and forms of exercise worldwide. Stress fractures are a common and potentially season-ending injury among competitive distance runners, with recurrence rates as high as 22%. Biomechanical factors, including running cadence, have been implicated in injury risk, but their precise role remains an area of active investigation. This literature review examines the relationship between cadence and stress fractures, drawing data from both observational and experimental studies. Observational studies suggest that low cadence and rearfoot striking are associated with increased risk of bone stress injuries. Experimental studies reinforce these findings, demonstrating that increased cadence …

Case Report: A Severe Case Of Post-Operative Ogilvie Syndrome Requiring Surgical Intervention, Aashna A. Chaudhry

Rowan-Virtua Research Day

Ogilvie Syndrome is an acute colonic pseudo-obstruction described as a paralysis of the colon with no real mechanical obstruction. This condition is oftentimes a benign post-surgical complication but can progress in severity if not treated appropriately. This case report presents a unique clinical case in which an adult female patient developed a severe case of Ogilvie syndrome postoperatively requiring surgical intervention.

Identification Of Subarachnoid Hemorrhage: The Impact Of A Nurse Led Screening Tool Utilizing The Ottawa Rule, Chandra Brower, Shannon Krumvieda, Shalana Bolton

Nursing Posters

The ETC lacked a formal tirage process for identification of Subarachnoid Hemorrhage (SAH), which can lead to delayed treatment and suboptimal patient outcomes. Data showed SAH patients who presented to the Emergency Trauma Center (ETC) with headache (HA) and hypertension frequently had long wait times before evaluation by a provider.

Improving Monticello Emergency Department Stroke Door To Drug Time, Andrew Winter Eppa, Alea Stanger, Jessica Miller, Naomi Schneider, Kristi Patterson

Nursing Posters

The aim of this project is to decrease the Monticello ED Stroke Door to Drug measure performance from the baseline of 67 minutes in CY2024 to < 60 minutes by September 30, 2025.

Predicting Coronary Artery Calcium Using Abdominal Aorta And Visceral Artery Calcification, Jared Dixon, Sayf Al-Katib, Kiran Nandalur, Jacob Ghannam, Ali Beydoun, Desiree Clement

Posters

CAC scoring has emerged as a widely available, consistent, and reproducible means of assessing risk for major cardiovascular outcomes, especially useful in asymptomatic people for planning primary prevention interventions such as statins and aspirin.1 The Multiethnic Study of Atherosclerosis (MESA) demonstrated that a CAC score of 0 represents a less than 5 percent 10-year Atherosclerotic cardiovascular disease (ASCVD) risk. CAC scores 1-299 represent borderline to intermediate risk, and CAC score >300 represents a “high risk” 10 percent or greater 10-year ASCVD risk.2

When used correctly, CAC scoring is a powerful predictor of ASCVD risk and holds the key for many …

Knowledge, Attitudes, And Practices Regarding Antimicrobial Resistance And Antimicrobial Stewardship Among Healthcare Workers In Outpatient Medical Centers In Kenya: A Qualitative Study, Mary Kaniu, Wahu Gitakah, Rupali Jain, Ann Munyare, Rodney Adam, Aliza Monroe Wise

Paediatrics and Child Health, East Africa

Objective: Antimicrobial resistance (AMR) is a major global health threat with a projected 10 million deaths globally by 2050. Antimicrobial stewardship (AMS) programs are coordinated efforts involving doctors, nurses, pharmacists, and other healthcare providers. Understanding knowledge, attitudes, and practices of health providers is pivotal for implementing strategies to curb the spread of AMR. The aim of this study was to evaluate knowledge, attitudes, and practices surrounding AMR and AMS among healthcare workers in Kenya.

Design: A qualitative study using in-depth semi-structured interviews

Setting: 12 private outpatient clinics in Kenya.

Participants: Healthcare workers including administrators and clinicians. …

Associations Between Health Literacy And Comprehension Of Health Visits In A Community Setting, Amanda Romaya, Adel Andemeskel, Salim Abdul-Razak, Linda Dillon, Victoria Lucia

Posters

Low health literacy is a significant social determinant of health that is associated with poor health outcomes1-3. Bringing attention to health literacy will aid in promoting the health of the population. However little has been done to implement national policies and interventions that address patient health literacy, especially in a community setting4.

We hypothesized that our assessment of the identified patient population’s health literacy will not meet adequate standards and will indeed demonstrate a need for community-focused interventions

Comparative Long-Term Outcomes Of Cell Therapy And Cardiac Rehabilitation In The Treatment Of Non-Ischemic Dilated Cardiomyopathy, Awrush Sean Namazi, Susrut Dube, Jay Kishor Patel

Rowan-Virtua Research Day

This systematic review explores long-term treatment approaches for non-ischemic dilated cardiomyopathy, comparing cell therapy and cardiac rehabilitation. Cardiomyopathy is characterized by the progressive thinning and deterioration of cardiac muscle and is a significant cause of heart failure. Various treatment modalities have been developed to combat cardiomyopathy and prevent the onset of heart failure, with more recent efforts focusing on cell therapy—particularly allogeneic and autologous stem cell transplants. The efficacy of these novel treatments was compared to more established regimens, particularly cardiac rehabilitation. Studies demonstrate that both treatment modalities are associated with a significant overall improvement in ejection fraction (effect size …

An Analysis On Gender And Race For Burnout Among Michigan Internists, Elan Pszenica, Jookta Basu, Esha Ahmed, Hugo Davila

Posters

Burnout among physicians, particularly in the field of internal medicine, has become a significant concern in recent years. This condition is characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, which can have detrimental effects on both healthcare providers and patient care. 1 While burnout is a recognized issue globally, its impact on internal medicine physicians in Michigan has not been comprehensively studied. Understanding the unique stressors faced by these physicians is critical for developing targeted interventions to reduce burnout rates and improve the overall healthcare environment. Internal medicine physicians often face intense workloads, long hours, administrative …

The Impact Of Physician Vaccine Recommendation On The Pregnant Chaldean Population, Sylvia Kashat, Nelia Afonso

Posters

• A variety of factors contribute to modern vaccine hesitancy, including balancing the risks and benefits of vaccination and delayed negative outcomes. • An important population to consider are pregnant women and their fetus, as the immune compromised state may increase the burden of disease. • It is the duty of healthcare providers to properly educate mothers on the effectiveness of vaccination on vaccinetreatable and vaccine-preventable diseases. • A subgroup that has been impacted by this greatly in the metro-Detroit area is the Chaldean community. • With the Michigan Chaldean population being greater than 160,000, and most of the community …

The Effect Of Covid-19 On Total Joint Arthroplasty, Hailey Worstman, James E. Feng, Alex Miller, Drew Moore

Posters

• Arthritis is debilitating disease that is common throughout the U.S. For patients with refractory disease, total hip and knee arthroplasty, collectively known as total joint arthroplasty, are used for definitive management.1 •

Total joint arthroplasty, TJA, is one of the most common procedures in the U.S. and is typically inpatient in order to start physical therapy and promote joint mobility as soon as possible.

• Elective procedures, including total joint arthroplasties, were halted in March 2020 due to the pandemic.2,3

• When TJAs resumed they shifted towards outpatient procedures and at home physical therapy.4

• The impact of the …

Second-Site Periprosthetic Joint Infection After Subsequent Primary Hip Or Knee Arthroplasty, Daniel Nikolaidis, Devin Young, Andrew Steffensmeier, Robert Runner, Mark Karadsheh

Posters

Periprosthetic joint infections (PJI) can arise anytime in the lifetime of a patient. Therefore, patients who have multiple prosthetic joints are at risk for developing multiple PJIs. Polyarticular PJI can be classified as either synchronous or metachronous. Synchronous PJIs present simultaneously in two or more joints. Metachronous PJIs (MPJI) occur in two or more joints after a disease-free period. Incidence of MPJI varies in the literature from 8-20%.1

Known risk factors associated with MPJI include Rheumatoid Arthritis, sepsis or SIRS, infection with MRSA, ≥3 revision arthroplasties, longer length of stay in the hospital, and an index TKA PJI.2

Only a …

A Review Of Risk Factors For Postoperative Failure After Isolated Primary Medial Patellofemoral Ligament Reconstruction, Bilal Tarar, Ameen Suhrawardy, Clark Yin, Leonardo Cavinatto, Elizabeth Dennis, Jeffrey Fischgrund, Betina B. Hinckel

Posters

• Medial patellofemoral ligament reconstruction (MPFL-R) is a surgical treatment for patellar instability [1].

• Cases of post-operative recurrent dislocation and persistent instability may occur due to preexisting anatomic risk factors and technical errors in the procedure.

• Current rates of recurrent dislocation are reported to be up to 20% [2].

• Research Question: What anatomic and technical risk factors are associated with increased rates of recurrent dislocation after primary MPFL-R?

Metachronous Periprosthetic Joint Infection In Patients With Multiple Arthroplasties At Index Infection, Devin Young, Daniel Nikolaidis, Andrew Steffensmeier, Robert Runner, Mark Karadsheh

Posters

Periprosthetic joint infection (PJI) is a devastating complication of one of the most successful surgeries in medicine. About 1% to 2% of patients will develop PJI after primary total hip arthroplasty (THA) or primary total knee arthroplasty (TKA) [1]. The 5-year patient survival rate of THA PJI is estimated to be worse than that of common cancers, such as breast cancer [2]. The burden of this disease is likely to increase exponentially as the population ages and the number of patients undergoing total joint arthroplasties increases in the future [3].

Most devastating is what Murray et al deem as metachronous …

Gender And Racial Disparities In Pediatric Orthopaedic Surgery Fellows: A Decade-Long Analysis, Naomi Haque, Mazen Zamzam, Imran Bitar, Ehab Saleh

Posters

• The Association of American Medical Colleges (AAMC) has highlighted the increasing gender, racial, and ethnic diversity among medical student applicants, noting a significant rise in the number of underrepresented students.
• In the 2021-2022 academic year, there was an 18% increase in total applicants. The number of Black or African American applicants rose by 21%, with Black or African American students comprising 11.3% of matriculants in 2021, up from 9.5% the previous year. First-year students of Hispanic, Latino, or Spanish origin saw a 7.1% increase, making up 12.7% of matriculants. Additionally, women constituted 56.8% of applicants, 55.5% of matriculants, and 52.7% …

Measles, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Sealing The Leak: Transcatheter Repair Of Anterior Mitral Leaflet Perforation With Amplatzer Vascular Plug 4., Zeryab A Khan, Cody Carter, Jordan Luli, Nathan Marzlin, Johnathan Hatanelas, Lindsay Castle, Kevin Stiver, Laura Flannery, Steven J Yakubov, Carlos Sanchez

Heart and Vascular Articles

We document the first reported use of the Amplatzer Vascular Plug 4 for anterior mitral leaflet perforation repair in a 56-year-old male who had undergone valve-in-valve transcatheter aortic valve replacement. Previously reported cases involving the use of other occluder devices for mitral leaflet perforation repair either required guide catheter or delivery sheath exchanges, arteriovenous wire loop for deployment, or use of mitral transcatheter edge-to-edge repair for leaflet stability. Our case highlights the efficacy of the bilobar-designed Amplatzer Vascular Plug 4 for precise occlusion in anterior mitral leaflet perforation through antegrade-only delivery and safety through the simplification of procedural steps.

Double-Edged Sword: Troubleshooting "Wide-Complex Tachycardia" And "Palpitations" Caused By Gastric Neurostimulator., Tori Hensley, Ankur Shah, Jennifer J Miller, Jason R Foreman, Allen C Brown, Asim S Ahmed

Heart and Vascular Articles

No abstract provided.

Recurrent Endobronchial Coil Migration Associated With Needle Biopsy Following Pulmonary Artery Pseudoaneurysm Embolization., Michael H Koenig, Mina S Makary, Tejas Sinha, Jeffrey C Horowitz, Nicholas Pastis

Ambulatory and Primary Care Articles

Endobronchial coil migration is a rare complication of pulmonary artery embolization, occurring when coils erode through a vessel into an airway. We describe a patient who underwent embolization of pulmonary artery pseudoaneurysms associated with a lung mass. The unique aspect of this case is the development of recurrent endobronchial coil migration following a CT-guided core needle biopsy and a subsequent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of the mass. In both circumstances, the portion of the coil that migrated into the large airways was cut with endoscopic scissors and removed with a flexible bronchoscope. This case highlights that while cutting …

Recent And Future Trends In Osteopathic Orthopedic Surgery Residency Match Rates Following The Transition To A Single Accreditation System., Morgan Turnow, Minali Nemani, Nithin Gupta, Hayden Hartman, Taylor Manes, Tyler Williamson, Arianna Gianakos

Medical Education Articles

CONTEXT: Medical education in the United States has undergone significant changes, specifically within the osteopathic community. In 2020, a merger occurred between the American Osteopathic Association (AOA) and the Accreditation Council for Graduate Medical Education (ACGME), forming a single accreditation system (SAS) for graduate medical education and residency placement, with the purpose to create consistency within graduate medical education and to provide equal opportunities for applicants pursuing all specialties in medicine. However, osteopathic medical students, especially students applying to competitive residencies including orthopedic surgery, have faced challenges, raising concerns about future implications within this field.

OBJECTIVES: The main objective of …

Managing Refractory Epilepsy In A Resource Limited Setting—Doing More With Less, Ruta Yardi, Kurupath Radhakrishnan, Pauline Samia, Janet Wilson, Amza Ali

Paediatrics and Child Health, East Africa

Drug-resistant epilepsy (DRE) disproportionately affects individuals in low- and middle-income countries (LMIC), where access to affordable and effective care remains a significant challenge. Patients with DRE face high healthcare costs, inadequate access to epilepsy surgery, and limited availability of trained professionals. This review explores a multifaceted approach to managing DRE in resource-constrained settings. Key strategies include rational polypharmacy with cost-effective antiseizure medications (ASM), implementation of dietary therapies like the ketogenic diet, and cost-conscious presurgical evaluations. Enhancing emergency care systems, particularly for conditions like status epilepticus, is critical, as is the development of standardized diagnostic and treatment protocols and training programs …

Small For Gestational Age Sub-Groups Have Differential Morbidity, Growth And Neurodevelopment At Age 2: The Interbio-21st Newborn Study, Aris T. Papageorghiou, María C. Restrepo-Méndez, Rose Mcgready, Fernando C. Barros, Francois Nosten, Shama Munim, Roseline Ochieng, Rachel Craik, Hellen C. Barsosio, James A. Berkley

Paediatrics and Child Health, East Africa

Background :Small for Gestational Age (SGA) is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birth weight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterise distinct SGA sub-groups and assess their neonatal and early childhood health trajectories.

Objectives: To refine the classification of SGA by identifying sub-groups based on maternal, fetal, and environmental factors and evaluating their associations with neonatal morbidity, growth, and neurodevelopment at age 2.

Study Design: Prospective Cohort Study. In six …

Blood Culture Contamination With Ultrasound Iv, Nick Del Boccio

Articles, Abstracts, and Reports

No abstract provided.